AB1586 THE RHEUMATOLOGY WORKFORCE IN THE ARAB COUNTRIES: WHAT IS THE CURRENT STATUS AND WHAT ARE THE PROJECTED UNMET NEEDS?
Authors: N. Ziade, I. Hmamouchi, C. Haouichet, F. Baron, S. M. Al-Mayouf, N. A. Al-Ani, B. Masri, M. EL Rakaawi, L. Kibbi, M. Mashaleh, B. Zorkany, J. El Saleh, C. Dejaco, F. Abutiban
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The demand for rheumatology care is consistently exceeding the workforce worldwide, which negatively impacts the care of patients with rheumatic and musculoskeletal diseases (RMDs). The number of rheumatologists per 100,000 inhabitants varies between 0.94 in Latin America to 3.44 in Spain, with a desirable number of 1-2. However, the estimation of the current and projected rheumatology workforce is lacking in Arab countries. <h3>Objectives</h3> To investigate the current number of practicing rheumatologists in the ArLAR countries, provide an estimate of the expected number of rheumatologists in 10 years, and evaluate the current workload, practice profile, and waiting time for a consultation. <h3>Methods</h3> This cross-sectional survey study was conducted by the Arab League of Associations for Rheumatology (ArLAR) Research Group (ARCH) in 16 ArLAR countries in two parts. The first survey was addressed to national societies by e-mail to estimate the current and projected workforce. The second was an anonymous e-survey addressed to all Arab rheumatologists and rheumatology fellows elaborated by the study steering committee on the Google Forms platform and distributed using social media, WhatsApp, and mass e-mails to evaluate their practice profile, workload, and waiting time for a rheumatology consultation. <h3>Results</h3> The mean number of rheumatologists in the ArLAR countries was 0.84 per 100,000 inhabitants (mean age 47.5 years, 55% females), ranging from 0.06 in Sudan to 1.86 in Tunisia (Table 1). The crude number of rheumatologists is expected to increase by 50% in 2032, whereas a 20% parallel increase in the population is also expected, associated with a rise in demand due to an expected increase in RMDs; thus, the percentage per 100,000 inhabitants will increase only by 22%. Data from 446 rheumatologists and rheumatology fellows (mean age 43.9 years, 60.5% females) revealed that 72% worked full-time, 53% were employed in the public sector only, and 75% worked in an urban setting. The median income was 1,000-2,000 USD/ month. There was a certified rheumatology nurse in 25%, access to musculoskeletal ultrasound in 51%, and telemedicine implemented in 29% of practices. The average waiting time for a rheumatology consultation was 19.9 days and was associated with the region, working full-time, working in the public sector, higher income, and the presence of an infusion center at the rheumatology practice. <h3>Conclusion</h3> Considering a desirable arbitrary level of 1-2 rheumatologists/ 100,000 inhabitants, there is a current shortage of rheumatologists in the ArLAR countries, with significant heterogeneity among countries. The projected increase in rheumatologists will probably not match the rising demand for rheumatology care. Considering local demographic disparities and healthcare system differences, national authorities are urged to implement effective intervention plans to optimize the rheumatology workforce. <h3>Acknowledgements</h3> We acknowledge the contribution of the following rheumatologists and thank them for helping to promote the survey in their respective societies: Drs Walaa Abdel Rahman, Samar Al Emadi, Ayman Al Garf, Khaled Al Naqbi, Hanan Al Rayes, Rachid Bahriri, Elyes Bouajina, Hachemi Djoudi, Jamal El Saleh, Bassel Elzorkany, Suad Hashad, Batool Hassan, Layla Kazkaz, Aïcha Ladjouze, Suad Mohamed. <h3>Disclosure of Interests</h3> None Declared.